Insured through Humana? Local hospitals might not be an option for you

A contract dispute between a major health insurer and a healthcare services provider has limited thousands of customers’ — including some in Beaufort and Jasper Counties — access to benefits.

Since Oct. 1, Humana customers with commercial and Medicare Advantage plans have not had in-network access to Tenet Healthcare doctors and facilties — including Hilton Head and Coastal Carolina hospitals — Tenet spokesperson Lindsey Allumbaugh said Friday in an email to The Island Packet and Beaufort Gazette.

However, patients with those plans can still receive emergency care at those facilities’ emergency rooms, Allumbaugh said. And some patients might qualify for an extension of their in-network benefits, she said, suggesting Humana customers call their insurance provider.

The rift between Humana and Tenet began in July, according to Allumbaugh.

That’s when Tenet notified Humana that it would not renew the contract “under the existing terms,” Allumbaugh said.

During negotiations, Tenet agreed to accept certain Humana plans — “Medicare Advantage and exchange proposals,” according to Allumbaugh — but said “Humana refused to finalize an agreement for these products without an agreement on all other products and resulted in a disruption of access for tens of thousands of people.”

Humana spokesperson Nancy Hanewinckel offered a different perspective.

“Tenet unilaterally terminated its agreement with Humana for Medicare Advantage, commercial, Medicaid, individual major medical plans offered through the public exchange and TRICARE product offerings as of Sept. 30,” Hanewinckel wrote in an email to the newspapers Friday.

The newspapers sent three emails to and left two phone messages for Hanewinckel to find out how many customers in Beaufort and Jasper counties would be affected by the dispute. She had not provided those numbers by press time.

Hanewinckel said Humana remains in negotiations for a new contract, but Allumbaugh said that’s not accurate.

“Contrary to what Humana is communicating to the public, we are not currently engaged in negotiations,” Allumbaugh said, adding Tenet is “open to discussions.”

Tenet, which generated more than $18 billion in revenue in 2015, according to the New York Stock Exchange, is encouraging its patients to consider alternative in-network plans during open enrollment for benefits.

Humana, which generated more than $54 billion last year, shared with its customers information about alternative in-network facilities, doctors and specialists.

This story was originally published October 24, 2016 at 4:45 PM with the headline "Insured through Humana? Local hospitals might not be an option for you."